Scaphoid AVN – CT

This patient was referred for a CT to assess whether or not her scaphoid fracture was healing (this can be very difficult to determine based on plain radiographs alone). In addition to showing non-union – the fracture line through the scaphoid waist remains clearly visible, arrows – there is also dense sclerosis of the proximal pole of the scaphoid (*), a feature of AVN and one of the feared complications of scaphoid injuries. As you’ll remember, the blood supply to the scaphoid flows from its distal to its proximal poles, leaving the proximal aspect at risk of necrosis after a fracture.